While we served in different administrations, we faced similar challenges in trying to improve the nation’s health-care system. The basic goal was to improve the quality of the care delivered and moderate the costs. While there are several key reforms that will help us address this challenge, one idea that nearly all health leaders in…
The Medicare Shared Savings Program (MSSP), now in its sixth full performance year, is at a significant crossroads. In creating the MSSP, Congress envisioned that Medicare accountable care organizations (ACOs) could moderate Medicare spending and improve quality of care by providers taking greater responsibility for costs and quality. While MSSP ACOs have clearly improved the…
An avalanche of new pay proposals from the CMS seeks to reduce provider burden, so much so that it could undermine efforts to shift Medicare to a value-based system, doctors warned. The agency released a 1,400-page proposed rule July 12 that for the first time combined the annual physician fee schedule and the Medicare Quality…
Today, the Centers for Medicare & Medicaid Services (CMS) proposed significant changes to the Home Health Prospective Payment System to strengthen and modernize Medicare, drive value, and focus on individual patient needs rather than volume of care. Specifically, CMS is proposing changes to improve access to solutions via remote patient monitoring technology, and to update…
Home health agencies may soon be able to include the costs associated with remote patient monitoring into Medicare reimbursement. Under a proposed payment rule (PDF) released by the Centers for Medicare & Medicaid Services (CMS) on Monday, home health providers would be able to include the costs of remote patient monitoring as an allowable cost in…
A diverse group of accountable care organizations, insurers, patient advocacy and health IT companies want the federal government to require data sharing among providers to participate in Medicare. The organizations didn’t stop there. They also urged the Centers for Medicare & Medicaid Services (CMS) to use other policy levers to drive interoperability by requiring the…
Payers will now be able to work with companies like Uber or Lyft to provide transportation, for example, as part of a more complete set of benefits for the quickly growing MA population. CMS issued a final rule in May giving MA plans more flexibility in determining the types of supplemental benefits they can offer chronically…
If you’re scratching your head about the direction of Value-Based Health Care (VBHC) in Medicare, you’re not alone. The current mix includes a swirl of separate initiatives, some new and others recently re-labeled. As CMS pushes toward VBHC, providers may feel confused and frustrated as concepts emerge that will affect multiple programs. Within the last…
Medicare’s bundled payment programs are in an opportune position to produce additional savings and create a more cost-effective public payer program with certain revisions, a new white paper from USC Brookings explains. CMS’s current bundled payment programs would achieve greater cost effectiveness by extending acute hospital reimbursement and hospital-based bundled payment episodes, argued John A….
Earlier this week, CMS (the Centers for Medicare & Medicaid Services) Administrator Seema Verma remarked that “upside-only” ACOs (accountable care organizations) that do not take on downside risk have not generated enough results to date. Now, Healthcare Informatics has learned that a CMS rule is forthcoming that could shorten the duration ACOs can stay in…